CTICasesNeurofibromatosis Type 1 with Phrenic Nerve Neurofibromas and Left Hemidiaphragm Denervation after MPNST Treatment
[...]. Neurofibromatosis Type 1 with Phrenic Nerve Neurofibromas and Left Hemidiaphragm Denervation after MPNST Treatment. CTICases. Published October 8, 2026. https://cticases.com/c/v8mrx
Imaging findings
A man with neurofibromatosis type 1 and a long-standing malignant peripheral nerve sheath tumor at the left apex, treated with radiation and resection, has scoliosis with spinal rods and pedicle screws. There are extensive, almost continuous plexiform neurofibromas along both sides of the spine. Discrete neurofibromas also follow the right phrenic nerve. The left hemidiaphragm is elevated, and its crus and anterior muscle are thin and speckled with fat (myosteatosis), compared with normal muscle thickness on the right. A radiograph from 2019, before most of the apical tumor treatment, did not show the elevation.
Key takeaways
The phrenic nerve is just another nerve and can carry neurofibromas in NF1. A thin, fat-infiltrated hemidiaphragm crus and muscle (myosteatosis) is a CT sign of phrenic denervation. Comparing with older imaging helps decide whether the denervation came from the tumor or from its treatment. Here it appeared after radiation and resection of the apical tumor.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Chest Wall Chondrosarcoma Invading the Diaphragm and LiverNeoplastic
- Nodular Sarcoidosis with Necrotizing Granulomas and Parotid InvolvementAutoimmune
- Miliary Disseminated Histoplasmosis during Chemotherapy for Ovarian CancerInfection
- Spontaneous Collapse of a Covered Esophageal Stent Placed for Esophageal RuptureIatrogenic
- Intraparenchymal Pigtail Chest Tube Placement for Large PneumothoraxIatrogenic
- Infundibular Pulmonary Stenosis with Selective Left Pulmonary Artery EnlargementCongenital
See all cases from October 8, 2026 →
Related Neoplastic cases
- Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH)
- Squamous Cell Carcinoma of the Parotid Gland with Pulmonary Metastases in a Heart Transplant Recipient
- Hodgkin Lymphoma Presenting as a Masslike Right Upper Lobe Consolidation
- Thymoma with Thoracic Splenosis Proven by Ferumoxytol MRI
- Mediastinal Metastasis from Testicular Teratoma Mimicking Bronchogenic Cyst
- Pulmonary Metastases from Angiosarcoma Presenting as Recurrent Hemorrhage